H08072026 Regular Session

Adds to existing law to provide legislative approval for certain family personal care services.

MEDICAID -- Adds to existing law to provide legislative approval for certain family personal care services.

IntroducedIn CommitteeFloor VoteEnacted

STATEMENT OF PURPOSE

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This legislation directs the Department of Health and Welfare to seek a federal waiver to reinstitute the family personal care services (FPCS) program. This program would permit trained, legally responsible family members to be compensated for the provision of services to a disabled family member requiring a high level of care when another caregiver is not available. The FPCS program was in effect in Idaho from April 15, 2020 until July 15, 2025, when it was terminated due to department concern about over-utilization and lack of usage limits, with the representation made by the Department of Health and Welfare at the time of program termination that the intent was to reinstitute the program with limits and controls. This bill would limit FPCS to 1000 total participants for 25 hours per week. All eligible participants would have to be eligible for personal care services (PCS) to be provided by a non-legally-responsible provider.

FISCAL NOTE

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The 1000 potential FPCS participants are already eligible for $38,626,736 of PCS per year ($27,038,715 federal, $11,588,021 general fund). This legislation would have the following fiscal impact: For one-time personnel and system costs for design, build, and deployment: $150,497 in federal funds, $266,949 from General Fund; For ongoing annual operating and personnel costs: $542,803 in federal funds, $290,490 from General Fund; At full utilization, for ongoing annual cost of services: $21,353,961 in federal funds, $10,418,039 from General Fund. To the extent utilized, these expenditures would be deducted from the $38,626,736 of PCS services for which these recipients are already eligible. Thus, Idaho currently reimburses PCS at $24.44/hour, substantially below the rate of neighboring states (eg. Montana reimburses at $45.40/hour, Washington at $42.92/hr, Wyoming at $34.04/hr, Oregon at $39.40/hr). If this legislation is not passed and beneficiaries resort to successful litigation in lig

BILL TEXT

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LEGISLATURE OF THE STATE OF IDAHO Sixty-eighth Legislature Second Regular Session - 2026 IN THE HOUSE OF REPRESENTATIVES HOUSE BILL NO. 807 BY HEALTH AND WELFARE COMMITTEE AN ACT1 RELATING TO MEDICAID; AMENDING CHAPTER 22, TITLE 56, IDAHO CODE, BY THE AD-2 DITION OF A NEW SECTION 56-2208, IDAHO CODE, TO PROVIDE LEGISLATIVE AP-3 PROVAL FOR CERTAIN STATE PLAN AMENDMENTS AND WAIVERS AND TO ESTABLISH4 PROVISIONS REGARDING FAMILY PERSONAL CARE SERVICES; AND DECLARING AN5 EMERGENCY.6

Be It Enacted by the Legislature of the State of Idaho:7

SECTION 1. That Chapter 22, Title 56, Idaho Code, be, and the same is8 hereby amended by the addition thereto of a NEW SECTION, to be known and des-9 ignated as Section 56-2208, Idaho Code, and to read as follows:10 56-2208. LEGISLATIVE APPROVAL -- FAMILY PERSONAL CARE SERVICES. (1)11 The department of health and welfare is authorized to and shall submit to the12 centers for medicare and medicaid services all state plan and waiver author-13 ities required to allow for legally responsible individuals to provide per-14 sonal care services.15 (2) Personal care services provided by a legally responsible individ-16 ual pursuant to this section shall:17 (a) Be limited to twenty-five (25) hours per week at the assessed level18 of care as determined by the department of health and welfare; and19 (b) Be subject to oversight as deemed necessary by the department of20 health and welfare.21 (3) Nothing in this section shall be construed to prohibit an individ-22 ual who requires more than twenty-five (25) hours per week of personal care23 services from receiving such additional care from a non-legally responsible24 individual in accordance with applicable law.25 (4) The number of legally responsible individuals authorized to pro-26 vide personal care services at one time pursuant to this section shall not27 exceed one thousand (1,000).28 (5) The department of health and welfare may promulgate rules, subject29 to legislative approval, to establish procedures regarding the creation and30 management of a wait list and otherwise carry out the provisions of this sec-31 tion.32

SECTION 2. An emergency existing therefor, which emergency is hereby33 declared to exist, this act shall be in full force and effect on and after its34 passage and approval.35